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Regional Centers and the Lanterman Act

In California, the Lanterman Act entitles people with developmental disabilities to a wide range of services and supports. This can include communication supports. These services are coordinated by a system of Regional Centers, which may also fund some of these supports directly.

Who is Entitled to Services through the Lanterman Act?

Anyone with a developmental disability is covered by the Lanterman Act, regardless of age. A developmental disability covered under this Act is a disability that originates before an individual attains 18 years of age; continues, or can be expected to continue, indefinitely; and constitutes a substantial disability for that individual. A substantial disability means significant functional limitations in three or more of the following areas of major life activity:

Self–care,

Receptive and expressive language,

Learning,

Mobility,

Self–direction,

Capacity for independent living, and

Economic self–sufficiency.

What Services are Available under the Lanterman Act?

Regional Centers also fund many services. These can include:

Assessment and diagnosis

Counseling

Individualized planning supports

Directly providing supports and services that are not covered through other sources

Independent living programs that help support adults to live in their own homes

Self-determination programs, which give people a budget that they can use to purchase the services and supports they need to live independently and exercise greater autonomy.

Regional Centers also help coordinate and access services that are funded through other programs. For example, they may:

Help people understand which resources are available in the community

Help people apply for services in the community, such as Vocational Rehabilitation and Medicaid services

Connect people to programs that protect and advocate for individuals' legal rights

Regional Centers specifically must either fund or help people access certain supports that help with communication, self-determination, and independent living. These can include:

Personal assistants to help an individual communicate or use a communication device

Interventions aimed at improving communication, such as speech-language therapy and occupational therapy

Service coordination services that help ensure continuity of access to communication devices and supports

Payor of Last Resort

Regional Centers are payors of last resort. This means that if a service is available through certain state or federal programs - such as Medicaid, the public school system, or private insurance - the regional center is not allowed to pay for it. Regional Centers cannot directly pay for services that are available through:

Medi-Cal (Medicaid)

Medicare

The Civilian Health and Medical Program for Uniform Services

In-Home Support Services

California Children's Services

private insurance, or

a health care service plan

Cal. Welfare and Institutions Code Section 4659. Exceptions can be made when the person with a disability is under three years of age, when the individual is still in the process of applying for coverage of those services, or when these programs have issued a letter denying coverage for these services.

The Regional Center is also required to investigate other sources of payment for services, even sources that are not on that list, but is allowed to pay for such services in the meantime. For example, Regional Centers may be required to investigate whether or not a service can be funded through the Vocational Rehabilitation program. However, the Regional Center can pay for a service that could be available through Vocational Rehabilitation. This is important because both Vocational Rehabilitation agencies and Regional Centers are supposedly payors of last resort. By allowing Regional Centers to pay for services that could also be available through Vocational Rehabilitation, the law allows Regional Centers to develop cooperative agreements with Vocational Rehabilitation that allow them to decide for themselves who will cover which costs. Otherwise, Regional Center clients may be stuck getting bounced between these agencies and not receive the services they need.

How Does One Access Services under the Lanterman Act?

To get services through the Lanterman Act, a person must be evaluated and determined eligible by the Regional Center. Once the person is found eligible, the Regional Center will work with the individual to create an Individual Program Plan (IPP). The IPP will list the individual's needs and goals. It will also include a list of supports that the individual will receive, either directly through the Regional Center or through other programs. The Regional Center will help the individual go through the necessary steps to access supports in the IPP that are to be provided through other programs.

The IPP is developed through a team process. The team includes not only the regional center and the individual but also members of the individual's support network. Once the IPP is signed, the Regional Center cannot make significant changes without providing notice and an opportunity to object.

If an individual does not believe that the IPP provides adequate services, the individual can object to the IPP. Objecting to the IPP triggers a dispute resolution process that may result in a hearing. People may ask for assistance with the appeals process by contacting the Clients’ Rights Advocate and Area Board. These offices can then appoint someone to help the individual with his or her appeal.

The appeals process is similar to the process of appealing Medicaid or health insurance decisions in that the person filing an appeal may be required to provide documentation and explanation of the need for the service he or she is seeking. However, it is also different from the process of appealing a Medicaid or health insurance decision in that it may also require the individual to testify in person before an Administrative Law Judge. People may even present witnesses at the hearing. If the person filing an appeal needs help testifying or will need a communication supporter present, it is important to make this request well in advance of the hearing. For more on the appeals process, read Disability Rights California's guide to the dispute resolution process.